ENC fentanyl deaths outnumber heroin: One person’s high is another's flat line

By Kelsey Stiglitz The Daily News

Monday

Jun 11, 2018 at 2:01 AM

Across the board, with the exception of Duplin County, fentanyl fatal overdoses outnumbered heroin deaths in ENC counties - by at least double.

Nearly 100 people in Eastern North Carolina have lost their lives in recent years due to fentanyl overdoses.

Across the board, with the exception of Duplin County, fentanyl fatal overdoses outnumbered heroin deaths in ENC counties - by at least double.

A synthetic opioid, fentanyl is taking on a deadly presence in the opioid epidemic - with many people unaware of just how dangerous it is.

Statewide, 1,661 overdose deaths were caused by fentanyl whereas heroin caused 1,056 in 2016-2017, according to the state medical examiner's office.

Fentanyl fatalities surpassing heroin deaths

Fentanyl, sometimes seen as a prescription painkiller used for severe pain treatment in cancer patients, caused 635 more overdose deaths in Eastern North Carolina than heroin last year.

According to a report from the N.C. Medical Examiner’s Office, heroin deaths have risen in a massive spike over the past five years, with a 1,119 percent increase from 2010-2016 - deaths jumped from 47 in 2010 to 573 in 2016. Fentanyl and related drug overdoses are on the rise as well.

Almost half of the 2017 fentanyl-related fatalities were caused by fentanyl or varieties of fentanyl, according to the report.

In ENC, heroin overdoses, although still present, were outnumbered by fentanyl cases in nearly every county for 2016-2017. The report noted the following number of fentanyl-related fatalities for this time frame:

Kelli Knapp, a certified substance abuse consultant, said the sheer potency of fentanyl is what makes it so dangerous.

“A lot of people are uneducated about how strong fentanyl is,” she said. “When you’re talking to people with addiction, you can tell them how dangerous drugs are, but they have friends who have (tried them) with no consequences."

Knapp said it’s these sort of experiences that can lead to a slippery slope when it comes to drugs like fentanyl, because one person’s high may be another person’s flat line. And in some cases, people have unknowingly come in contact with a fentanyl patch with fatal consequences.

Different forms of fentanyl and other synthetic opioids are making their way to the street, usually by ways of illicit manufacturing, according to the medical examiner’s report.

Thomas said fentanyl is near impossible to make in a home lab and is usually shipped from China or Mexico.

“It’s hard to make it - it’s generally made in a lab where they might not know what they’re doing and shipped here,” Thomas said.

Knapp added that misconceptions can be harmful. Fentanyl acts like an opioid, so those with addiction may turn to the lethal drug in place of other drugs, like heroin.

Emergency response

According to David Grovdahl, Onslow County Emergency Services Division Head, there was a 46 percent increase in calls about opioid overdose in 2017. EMS predicts they'll receive 500 calls related to overdoses in 2018.

One of the factors that has brought new training to local EMS agencies is not Narcan treatment, but situational training, Grovdahl wrote in an email to The Daily News.

“EMS providers are more suspect for opioid abuse than before and receive more training on dealing with the social and peripheral issues associated with overdose,” Grovdahl wrote.

Stanley Kite, director of Craven County Emergency Services, agreed.

“The rest of the medical staff is already familiar with Narcan, but we provide additional training for law enforcement and other first responders in addition to CPR,” Kite said.

With Craven County’s high count of fatal fentanyl cases, Kite said EMS noticed a spike in the fall of 2017 for overdoses.

“We’ve kind of been on a roller coaster,” Kite said.

Like the other counties in ENC, James Hood, commander of the Lenoir County Emergency Services EMS Division, said EMS has helped train law enforcement and first responders in the use of Narcan.

“For the public, we have gotten kits from various sources and we have distributed those out to the public as needed,” Hood said.

Kite said law enforcement in Craven are beginning to travel with Narcan as well.

“Since the addition of Narcan and getting more of it out to first responders and other people out there, the deaths seem to have dropped,” Kite said.

Narcan kits, he said, are also available to family members or caregivers through Craven County EMS. To request a kit, call 252-636-6608.

Keeping first responders safe

Hood said calls on overdoses vary from month to month for Lenoir EMS, and training has been updated to include personal protection measures for Kinston first responders.

“If we see the substance then we may put on two pairs of gloves, remove the patient from that environment and we would use respiratory protection we normally wouldn’t use,” Hood said.

Luckily, he added, Lenoir EMS has not encountered a situation like that yet, but the added awareness helps.

Onslow County is practicing preventative measures, too, Thomas said. For cases involving fentanyl, extra precautions are required because it can be absorbed through the skin.

For now, first responders are focused on battling the problem - and Kite said having first responders administer Narcan in Craven County has improved the chances of lowering their high number of deaths.

“It’s not a cure, but our position is if we’re going to save a life we’re going to save a life," he said.

Fighting back

Knapp said the Onslow County Substance Abuse Prevention Task Force, of which she is a member, is just starting to get the word out about fentanyl.

She believes education is key in prevention, and tracking overdoses - like ENC is doing - plays a role in it.

“We need to be more proactive than we have in the past,” Knapp said.

For law enforcement and medical professionals, knowing what drugs are killing people can help keep the community one step ahead, Knapp added.

Knapp said the task force is specifically working to educate the public on the dangers of fentanyl, especially when mixed with heroin, which has led to deadly consequences for so many already.

“These people don’t know what they’re getting,” Knapp said.

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